MEDICARE: DR. DENNIS RICHARD FEE D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS028272L	PA

General Provider Information

NPI Number	:	1710976600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS RICHARD FEE D.M.D.

Provider Business Mailing Address
First Line	:	321 S 25TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-6403
Country	:	US
Telephone Number	:	267-847-3894
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 LOCUST ST STE 100
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-4204
Country	:	US
Telephone Number	:	215-560-8104
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	10/21/2020

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